The transition to adulthood

This section talks about the steps towards adulthood, including education, relationships, sexuality, drugs and alcohol.

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Our teenage years can be a time of struggle for any of us.
As our hormones bring about massive change in our bodies, there is also a great deal of upheaval in our personal lives.
Young people are making decisions about their future, sometimes for the first time in their lives.They may also be under different kinds of social pressure, and it’s in these formative years that drugs, alcohol and sexuality may become things young people need to think about.
In short, our teenage years are when we make some of our most important steps towards adulthood.
An acquired brain injury can make these difficult choices that little bit more complex.
Deciding whether or not to stay on in full-time education is a big decision for most teenagers.
But for a young person with an acquired brain injury, there may be other things to consider.1
On a very practical level, a young person with an acquired brain injury may start to access adult services during their teenage years.2
This is a shift in itself.

As well as these practical things, there is an emotional aspect to consider. We are at our most self-conscious when we’re teenagers.
Most young people are keen to ‘fit in’ and social situations may be difficult for some children with an acquired brain injury.3, 4
They may be anxious about the effects of their injury on taking part in sport, socialising or dating.5
Some young people with an acquired brain injury may feel ‘out on a limb’ and distant from people their own age.
This in turn can make parents feel anxious, as their son or daughter heads out into the world under their own steam.6

All young people face tough decisions as they think about whether or not to stay on at school.
If they do, there may be questions about what qualifications and subjects are going to suit them.
If a young person has a statement of Special Education Needs, then the annual review in year nine is particularly important.7

This review is very much about the steps into adult life.
It is in this meeting that important transition plans should be made (the meeting may well include other things as well).
The review can involve all of the people and organisations who have a role to play when your child leaves school, whenever that might be.
These might include your local careers service (sometimes called Connexions) which helps all young people between 13 and 19 prepare for adult life.
It might also include your local social services department.
Like other reviews, this meeting will discuss your child’s targets and their statement.
But this year nine meeting will discuss a ‘Transition Plan’ for a/yourchild’s move towards adult life.
It’s an action plan that aims to set out the steps needed to move from school life to adult life.
It may start with your child working with a Connexions/careers adviser.
It’s up to the head teacher to make sure the Transition Plan is completed after the year nine annual review.
This plan is very much about where children see themselves, and what qualifications they might need to get there.7
Sometimes this is called a ‘Moving On’ plan.
The transition plan is not set in stone. It can be discussed and changed at later review meetings.
But as always, parent and child should be asked to help with this plan.

There are a range of options ahead of a young person after 16.
Depending on their interests and abilities, they can stay on at a mainstream school.
If there is a relevant curriculum for them, they may be able to stay on at a special school.
Alternatively, they might want to move on to a college of further education or some form of work-based training.
Lots of schools have developed ‘link’ courses with local colleges, so pupils in their last years at school can go to college on a part-time basis.
This can be a good way of ‘testing the water’, by preparing young people for further education and giving them the chance to sample new subjects that might interest them.
Further education is available for every young person over 16.
If a/yourchild has a statement of special educational needs, everyone involved in transition planning will consider what the options are.
If your child has a statement of special educational needs and wants to leave school at the end of year 11 to go on to a further education college or to work-based training, the jobs advisor will carry out an assessment.

Must a child have a Statement of Special Educational Needs to benefit from support?

No. The local careers service can carry out these assessments for other young people with special educational needs who want to go on to further education or training.
They will work with further education colleges and training providers to make sure the young person gets the help they need.

What about university?

Universities and colleges of higher education offer education beyond A levels, AS levels or NVQs from the age of 18.
It is open to all young people who have the required qualifications to be accepted by an institution.
Different universities will have very different entry requirements.

Employment

Our teenage years are when our sexuality emerges more rapidly.
The rush of feelings and urges can be overwhelming for many teenagers. And it’s complicated by social situations and pressures.
Many young people with acquired brain injury are no different from the youngsters around them in feeling pressure to develop relationships with a boyfriend or girlfriend.8
Many young people want to fit in, but understandably, parents may feel protective and concerned for their children.
There are some young people with an acquired brain injury who may be vulnerable, and this may cause genuine distress to parents.4
Some children and young people with acquired brain injury struggle to understand ‘cause and effect’ relationships (if I do X, then Y will happen).
This may make it difficult to make informed decisions.
We also know that judgment and the ability to make decisions can be affected.9
A young person with an acquired brain injury can also act impulsively. They may not think things through.10
So if a young person experiences some or all of the effects mentioned above, they may not be able to make sound judgments about sex and relationships.Important to note, however, is that this will not be the case for all young people with acquired brain injury.
Many are capable of, and are entitled to, the same relationships all young people have.
Talking about sex is rarely easy, but communication is key here.
Some parents may feel their child’s change in circumstances makes talking about sex irrelevant.
Some might worry about “giving them ideas” in talking through some of the issues.11
But – as with all young people – education about sex is extremely important.
Young people may need information about what sex involves on a physical level, and contraception.12

What can parents do to help?The differences in circumstances make it difficult to offer any hard and fast rules.
But there are some approaches that may help with the organisational side of things.
If a young person or child struggles with memory or planning, then going over the steps with them can help.
Sometimes, prompt sheets can help, setting out these individual steps.

As young people move towards greater independence through education, work and their personal lives, part of this transition is about them taking responsibility for their own health.
In theory, young people should move from paediatric to adult wards at 16. And in other circumstances, the move to adult services should take place at 18.The Transition Information Network is a website for people who support disabled young people in transition to adulthood.
It provides information about the transition process that is of use to parents, carers, and professionals.
There is also a section for young people that talks about the transition process and gives links to helpful resources.

National Service Framework for Children. Transition: Getting it right for young people. Improving the transition of young people with long term conditions from children's to adult health services, p14, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4089100

Special educational needs and disability code of practice: 0 to 25 years (2014). Department for Education and Department of Health.
available at:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/342440/SEND_Code_of_Practice_approved_by_Parliament_29.07.14.pdf

"Up for Anything", a presentation from Rita Grieves, clinical support manager at JSP ltd.